VA OIG: Outsourced C&P Exam Issues Caused Wrongfully Denied VA Claims

[@chrisaskfotiy967]

My Doctor of 20 years filled out a DBQ, the medical records from the past 8 years, including medical records from a specialist, and my Active Duty medical records with the diagnosis. I submitted them with a claim, first time, an ACE review by a Nurse Practitioner, denied stating there was no nexus, and my injury was likely hereditary, and due to my age. I asked for a HLR, the reviewer found a Duty to Assist error, and kicked it back down. I then get notified I of a C&P Exam, by a Physicians Assistant. I brought my AD Records where it was diagnosed, all of my private Doctors notes and records, as well as a copy of the DBQ. Should be no surprise, denied SC again, same reason. Ask for another HLR, explain it's in my AD records, everything was submitted, no one else in my family has ever had the injury, or any associated conditions. Another Duty to Assist, kicked back down, and a 3rd C&P is ordered. That C&P was done by a Chiropractor, he said there was not enough sufficient evidence to support the prior diagnosis, but could not determine if the issue was caused by, occurred in, or aggravated by my active duty. This time I was awarded SC, but how much did the VA spend on C&P Exams? I submitted everything they needed to make a decision, yet they spend $$$$ on the exams, and all were sent to a single contract exam company, who made out like a bandit.

[@Juanvaldez-u5j]

Brother. I could have written your exact story from my experience. I recently had my 5th CP exam and still no service connection. It's my understanding that the contracting company that has done my exams charges about $3,300.00 per exam, so about $16,500.00 so far. I was hospitalized for a back injury while on duty and diagnosed with the injury during every exam but nexus is still denied. Crazy.

[@spec46971]

I was recently denied for a claim for advanced degenerative arthritis in my left ankle examiner noted my age as the reason it clearly states in 38CFR 4.19 that age cannot be a factor in deciding a compensation claim

[@Juanvaldez-u5j]

@@spec46971 Resubmit brother, VA raters are just like us. They make mistakes too. You know you deserve it, keep trying.

[@Bigotes1775]

Thank you ladies. Freaking outstanding work.

[@GAvet4lyfe]

This has been known for years, and nobody cares except us Vets who continue to be denied of benefits we deserve! What if this vet would have given up, this problem is bigger than the VA will admit!

[@David-cv3bp]

Nice video, important issue! I had a c&p exam scheduled, showed up. The lady says she doesn’t see Optus patients that day. I call the scheduler, she speaks with women and confers they will reschedule. I said ok, but I just drove 43 miles one way for over an hour I want to be paid. After awhile on phone the scheduler says ok, she annotated to be paid. 4 months later still no pay, I call and Optus scheduler wants proof I was there! I said see the previous record, they said they see it, but need proof! Amazing! Never paid for a wasted trip!

[@Cole_Pfeiffer_has_a_Fake_Hand]

When these C&P examiners start losing their medical licenses, things will change-that is the only way to solve this problem

[@BR54966]

EXCELLENT POST CC&K. SPOT ON TOPIC

[@ronbliss7368]

Everyone of my recent c&p exams were horrid. My audiology c&p, if the testing room was bigger than a jail cell, I would do a cartwheel (which I cant) and she said " I HAVEN'T READ OVER YOUR OTHER TESTS" not even 5 days later, denied. My latest for COPD w/emphysema C&P, 30 minutes tops, again DENIED

[@denisehennington9807]

My husband's examiner joked with him about being Superman, & laughed. While she was measuring his hernia scar. Never asked him if he wore a truss. Put in her report he wasn't wearing one. Even though he was in a wheelchair wearing an undergarment.

[@sillygoose4176]

My best CNP exam was with a female va DR. Worse CNPs were always with hired gun contract CNP examiners because they will get more business from the VA if they deny most things. I've heard that from VA employees

[@jeffthomas4060]

Reporting "issues with your exam to the VA" does nothing. It falls on deaf ears and is ignored. I can speak from experience and after almost three years won my higher level review. The C&P examiner failed to document and only scolded me for filing a claim. I ultimately won and will never have to go through another C&P abusive exam.

[@scrapguy6816]

Alot of C&P exams are inadequate. Only a very few examiners are in it to do there jobs and help veterans.

[@joeking4100]

I have had the same issue with unnecessary scheduled exams.

[@panamacitybeachbum]

Primary reason how CC&K is able to keep their doors open

[@SydneyReader]

How to report an issue with a contract C&P? I had a musculoskeletal exam with Optum and the guy did not do any range of motion measurements. When I asked during the exam, he said it wasn’t required (ROM is part of rating criteria). I called the VA after to report the issue and never got my call returned. I did file a FOIA for my c-file.

[@markcinco8405]

The problem is ROs who have the attitude that we are enemies attacking them and they are heroes for protecting their jobs from us. They have no fear of retribution or consequences because what they have is absolute power.

[@lg7728]

My first VA contract exam was 2009 and the last one was 2013. I rate the exams a 9 from a scale of 10. I don't have any complaints.

[@andycharles6921]

I had a C&P exam for lung cancer that I was receiving radiation therapy for and the VA had a doctor give me a PHONE EXAM,not even a zoom ,but a phone call! Still do not know the outcome.

[@ronbliss7368]

Is anyone surprised

[@builtnotboughtmadeinphilip3955]

My CnP exam was 20 minutes for mental. The dude had no records forwarded from VA. He asked a few questions and cut me off when I started to talk about my condition

[@chiquitagriswell3437]

I drove 30 minutes for a 10 minute “exam” -really it was about 5 questions-then I was asked to upload records to them.

[@JeannyWantschange]

C&P exams are a joke! I had 3 in 3 months…then VA sends me back for the exact exams, 2 months later!!!! VA needs to get a GRIP on what they are doing! Causes too much stress and anxiety for Vets!!! Learn their jobs or fire them.

[@SOCORROGM]

Even better veterans weren't sent notices of cp exams like me. Claim denied failure to show. Va reported 1000's were never sent out do to error by the VA

[@veronicarodriguezabrego7623]

I had a bad experience with an examiner and try reporting but unsuccessful. VA was like oh well

[@OnlyRoseVelvet]

After 2011 I went in for excam for tititus, and the male examiner told me house wife's get that. I told him I wasn't a housewife. I worked on the flight deck. And then went for another excam which I believe was a dr asked if I could work. I said yes. She said she would put down I couldn't because she works for me. No, that screws me over. I dislike the examiners. And put down I was overweight. Which I am which the VA said my brain tumor was from being overweight when there is no medical evidence to support that and online said obesity. Not just being overweight. And they don't even know what my weight was when I got it. I got denied without excam because the guy had some kind of vendetta. I appealed got an excam and got approved. But they want to screw us over left and right.

[@anthonywashington512]

On the day of the 47th President’s inauguration and Martin Luther King Jr day. I motion Congress to pass legislation creating a new medical and benefit provider for veterans outside of the Department of Veterans Affairs.

[@alexanderyoung6037]

These examiners are nurse practitioners not specialized in particular medical skills

[@thomasromano1724]

Bla bla bla is a bla mental health game